Prosthetic Rehabilitation of a Marginally Resected Mandibular Arch With a Metal Reinforced Telescopic Overdenture

Success of the prosthesis after mandibular resection is related directly to the amount of the remaining bone and soft tissue present. The prognosis for mandibulectomy patients becomes less favorable as the size of the resection increases. Prosthetic rehabilitation for such patients is a challenge for clinicians. Without preprosthetic reconstructive surgery, denture fabrication for mandibulectomy patients becomes extremely difficult. Telescopic dentures is a modality of treatment consisting of an inner or primary telescopic coping which is permanently cemented to an abutment and an outer or secondary telescopic coping which is attached to the prosthesis. These copings protect the abutment from dental caries and thermal irritations and also provide retention and stabilization of the secondary coping. The secondary coping engages the primary copings to form a telescopic unit and it provides retention and stability to the prosthesis. This clinical report aims at utilizing the remaining natural teeth for a mandibular overdenture with telescopic coping.     

Full Mouth Rehabilitation with Maxillary Tooth Supported and Mandibular Tooth and Implant Supported Combination Prostheses: A 4-Year Case Report

The primary objectives of successful prosthetic rehabilitation are to provide function, esthetics and comfort to the patient. Combination prosthesis is one which is supported by both natural teeth and implant. The periodontal ligament and osseointegrated interface distribute force differently to the supporting bone. Therefore problems can develop when tooth and implants are combined in the same prosthesis. However, clinicians can apply biomechanical principles, to negate the deleterious leverages exerted by the fixed prosthesis by using non rigid components and to equalize the stress applied by the prosthesis on implant and teeth. A case of partially edentulous situation was rehabilitated successfully with a combination of prostheses. Maxillary arch was restored to function with crowns, fixed dental prosthesis and with an extra coronal castable attachment prosthesis and the mandibular arch with a combination of tooth and implant supported attachment prosthesis. The clinical and laboratory steps for the fabrication of these prostheses are explained in this report.     

联合支持早期种植修复前牙缺失临床观察

目的:观察应用非埋植型种植体与天然牙联合式支持早期修复前牙缺失的临床效果。方法:对73例前牙缺失患者植入95枚种植体并早期加载完成义齿修复,临床观察6～48个月。结果:成功率96.8%,修复体各项指标正常。结论:应用CDIC非埋植锥状种植体修复前牙缺失,采用种植牙——天然牙联合支持早期加载,可缩短修复周期,满足患者的美观要求。     

单个前牙种植体修复——五年的临床观察与分析

目的 :对比分析单个前牙种植体的传统临时冠修复和即刻烤瓷冠修复的临床效果。方法 :对1992年10月至1995年5月的我院共39例2组前牙种植患者 ,采用临床四级评分的半定量方法 ,观察5年后评估两种修复方法的临床效果。结果 :即刻烤瓷冠修复的临床效果明显优于临时冠修复。结论 :即刻烤瓷冠修复单个前牙种植体是一种切实可行的方法     

Prosthodontic Management of a Combination Transosteal/ Endosteal Implant Reconstruction: A Clinical Report

This is a clinical report of a patient who was not referred for prosthodontic evaluation and treatment until after undergoing Bränemark endosseous implant placement to supplement the previously existing mandibular staple bone plate implant. This supplemental treatment was the surgeon's attempt to resolve the patient's complaint of loose dentures. Creativity with implant biomechanics and prosthodontic design were necessary to restore the patient, in a predictable manner, to normal function. A fixed, detachable cast overdenture bar rigidly connected to all the implants was constructed utilizing resilient attachments to retain the tissue-supported mandibular overdenture. A presurgical prosthodontic evaluation could have averted many of the problems encountered with treatment. More effective conventional prosthodontic treatment may have resolved the patient's complaints and eliminated the need for additional implant placement.     

Dental Implant Therapy in a Patient with Acromegaly: A Clinical Report

Acromegaly is an adult endocrine disorder that results from excessive growth hormone after closure of the growth plates and is associated with significant morbidity and increased mortality. The orofacial features of patients with acromegaly are thick lips with a tendency towards mandibular overgrowth with prognathism, jaw thickening, maxillary widening, drifting of teeth, malocclusion, and increased gonial angle, all of which can challenge the prosthodontist in dental rehabilitation. Additionally, excessive secretion of growth hormone and insulin‐like growth factors have been shown to increase bone turnover, which in turn leads to weakening of bone microarchitecture and high risk of fragility fractures. This clinical report describes the 4‐year follow‐up of a 59‐year‐old white male with acromegaly, who was managed successfully by using dental implants for replacing his missing teeth. Considerations related to treatment planning, implant surgery, bone remodeling, and management of dental occlusion are discussed. This is the first clinical report in the dental literature describing the use of dental implants in an acromegaly patient.     

套简冠附着体义齿修复多数牙缺失的临床效果评价

目的探讨套筒冠附着体义齿修复多数牙缺失的临床效果。方法收集单颌多数牙缺失、仅余留2～6颗天然牙的患者15例,制作套筒冠义齿18件,随访6个月一2年,询问患者对义齿的主观感受、咀嚼效率、义齿固位和稳定性,摄X线全景片,了解义齿、基牙和牙周情况。结果患者普遍认为义齿易适应、美观、固位稳定性好、咀嚼有力。12例曾使用过传统可摘局部义齿的患者对比两种义齿,明显感觉套筒冠义齿更加舒适、美观、稳定。复查X线片示套筒冠修复后各基牙牙周膜正常,牙槽骨无明显吸收。结论套简冠义齿修复多数牙缺失的牙列缺损临床效果良好。     

A Simple Technique for Accurate Transfer of Secondary Copings in a Tooth‐Supported Telescopic Prosthesis

Residual ridge resorption is a rapid, progressive, irreversible, and inevitable process of bone resorption. Long‐standing teeth and implants have been shown to have maintained the bone around them without resorption. Thus, overdenture therapy has been proven to be beneficial in situations where few remaining teeth are present. In addition to the various advantages seen with tooth‐supported telescopic overdentures, a few shortcomings can also be expected, including unseating of the overdenture, increased bulk of the prosthesis, secondary caries, etc. The precise transfer of the secondary telescopic copings to maintain the spatial relationship, without any micromovement, remains the most critical step in ensuring the success of the tooth‐supported telescopic prosthesis. Thus, a simple and innovative technique of splinting the secondary copings was devised to prevent distortion and micromovement and maintain its spatial relationship.     

种植体支持的磁性固位与快套式下颌覆盖总义齿的比较

目的:比较种植体支持的磁性固位与快套式固位覆盖总义齿的临床应用情况。方法:22例无牙下颌患者按种植覆盖总义齿固位方式的不同分为二组,在戴牙二年后、四年后检测患者满意度、种植体周骨质吸收程度。结果:二组义齿的戴牙后满意度除固位力外无显著差异,但种植体周骨质吸收程度存在高度显著性差异。结论:种植体支持的磁性固位下颌覆盖总义齿种植体周的骨质吸收较少。     

Implant‐Supported Oral Rehabilitation of a Patient with Pemphigus Vulgaris: A Clinical Report

Pemphigus vulgaris (PV) is a rare mucocutaneous vesiculobullous disease characterized by the development of autoantibodies against the desmosomal proteins. Current treatment is largely based on systemic immunosuppression using systemic corticosteroids. Immunosuppressive drugs used in the treatment of the disease may increase the risk of infection and delayed healing, which are of concern in dental treatment procedures in this group of patients. The clinical outcomes of implants in PV have not been investigated. We present a case of PV rehabilitated with an implant‐supported prosthesis with a 32‐month follow‐up and discuss the important points in the surgical and prosthodontic phases.     

Implant‐Supported Obturator Overdenture for Extensive Maxillary Resection Patient: A Clinical Report

This clinical report presents an implant‐retained obturator overdenture solution for a Prosthodontic Diagnostic Index Class IV maxillectomy patient with a large oronasal communication and severe facial asymmetry, loss of upper lip and midfacial support, severe impairment of mastication, deglutition, phonetics, and speech intelligibility. Due to insufficient bone support to provide satisfactory zygomaticus implant anchorage, conventional implants were placed in the body of the left zygomatic arch and in the right maxillary tuberosity. Using a modified impression technique, a cobalt‐chromium alloy framework with three overdenture attachments was constructed to retain a complete maxillary obturator. Patient‐reported functional and quality of life measure outcomes were dramatically improved after treatment and at the two‐year follow‐up.     

A Transitional Overlay Partial Denture for a Young Patient: A Clinical Report

This clinical report describes a noninvasive approach for the treatment of a patient diagnosed with amelogenesis imperfecta (AI) and severe anterior open bite. The patient's functional and esthetic expectations were successfully met with a transitional overlay removable partial denture.     

Maxillary Rehabilitation Using a Removable Partial Denture with Attachments in a Cleft Lip and Palate Patient: A Clinical Report

Clefts of the lip and/or palate (CLP) are oral‐facial defects that affect health and overall quality of life. CLP patients often need multidisciplinary treatment to restore oral function and esthetics. This paper describes the oral rehabilitation of a CLP adult patient who had maxillary bone and tooth loss, resulting in decreased occlusal vertical dimension. Functional and cosmetic rehabilitation was achieved using a maxillary removable partial denture (RPD) attached to telescopic crowns. Attachment‐retained RPDs may be a cost‐effective alternative for oral rehabilitation in challenging cases with substantial loss of oral tissues, especially when treatment with fixed dental prostheses and/or dental implants is not possible.     

A Novel Approach for Converting a Mandibular Complete Denture to a Fixed Interim,Screw‐Retained Implant Prostheses: A Case Report

For most of the last century, conventional complete dentures have been the standard of care and the most common treatment for edentulous patients. Technological advancements in fabrication techniques may significantly reduce the number of office visits required to fabricate complete dentures. Immediate occlusal loading with mandibular full arch prostheses has been extensively researched and is now one of the standards of care for edentulous patients. A clinical technique for converting a mandibular immediate complete denture to an interim full arch, screw‐retained fixed prosthesis with novel implant restorative components for immediate loading on four implants is described.     

Management of Maxillary Cluster Implant Failures with Extra‐Maxillary Implants: A Clinical Report

Late cluster implant failures can be one of the most devasting outcomes of implant therapy for patients. It can have anatomic, functional, psychological and financial consequences for patients, and sometimes the loss of residual bone can preclude subsequent implant placement. Fortunately, management of cluster implant failures in the maxilla can be mitigated by using implant anchorage from remote sites like zygomatic and pterygoid regions. Few reports exist in the literature that have described the management of cluster implant failure using extra‐maxillary implants such as zygomatic and pterygoid implants. This case report describes the management of a female patient with bruxism who experienced late cluster implant failure in the maxilla after 9 years of function with an overdenture. Due to the loss of residual bone, subsequent implant therapy involved the use of bilateral zygomatic, pterygoid and anterior maxillary implants, which were immediately loaded and thereafter used to support a complete arch fixed implant‐supported zirconia prosthesis.     

A Novel Extended Range Attachment System to Retain Implant Overdentures: A Clinical Report

Various attachment systems have been used to facilitate the retention, stability, and support of overdentures. The low profile design, pivoting technology, and durability of the Locator attachment made it one of the commonly used tissue‐supported implant‐retained overdentures. It has been successfully used to retain overdentures as well as partial dentures. This article describes the uses of the new Locator R‐Tx abutment and illustrates both the direct and indirect techniques used to process the denture attachment housing into the prosthesis to retain overdentures and partial dentures.     

An Alternative Design to Overcome the Problem of Unfavorable Implant Angulations for a Screw‐Retained,Implant‐Supported Fixed Prosthesis: Two Clinical Reports

Two clinical reports present an alternative design to address the problem of unfavorable implant angulations if a screw‐retained prosthesis is desired. The restorations were designed as screw‐retained prostheses, except in the area with the unfavorable implant screw emergence. The frameworks in these areas were customized to receive individual cement‐retained crowns. This design offers retrievability and helps to minimize complications associated with excess cement without compromising the functional or esthetic outcome.     

An Alternative Technique for the Fabrication of a Metal‐Reinforced Interim Implant‐Supported Fixed Prosthesis: A Clinical Report

Despite advancements in restorative materials and techniques, complications with implant‐supported fixed prostheses such as veneer fracture and material wear are very common and present with varying frequencies. Following these complications, repair of this type of prosthesis can be time‐consuming and costly even in the hand of experience clinicians. Several techniques have proposed using the existing framework to minimize the cost of the repair for the patient; however, while the repairs are being performed, the patient will have to either wear an interim complete denture or no prosthesis, which might cause some inconvenience to the patient. This article will present a technique for the fabrication of a metal‐reinforced interim implant‐supported fixed prosthesis for patients to wear while the existing prosthesis is being repaired.